Examining the efficacy of vibrotactile displays for monitoring patient vital signs: Six laboratory studies of change detection and state identification.

Healthcare workers often monitor patients while moving between different locations and tasks, and away from conventional monitoring displays. Vibrotactile displays can provide patient information in vibrotactile patterns that are felt regardless of the worker's location. We examined how effectively participants could identify changes in vibrotactile representations of patient heart rate (HR) and oxygen saturation (SpO2). In Experiment 1, participants identified changes in HR and SpO2 with greater than 90% accuracy while using vibrotactile displays configured in either an integrated or a separated format. In Experiment 2, incidental auditory and visual cues were removed and performance was still greater than 90% for the integrated display. In Experiments 3 and 4, ongoing tasks with low or high task load were introduced; high load worsened participants' response accuracy and speed at identifying vital signs. In Experiments 5 and 6, alternative designs were tested, including a design with a seemingly more natural mapping of HR to vibrotactile stimulation. However, no design supported more accurate performance than the integrated display. Results are interpreted with respect to multiple resource theory, and constraints on conforming to design guidelines are noted. Vibrotactile displays appear to be viable and therefore potentially suitable for use in healthcare and other contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Interruptions to Intensive Care Nurses and Clinical Errors and Procedural Failures: A Controlled Study of Causal Connection.

OBJECTIVES: Interruptions occur frequently in the intensive care unit (ICU) and are associated with errors. To date, no causal connection has been established between interruptions and errors in healthcare. It is important to know whether interruptions directly cause errors before implementing interventions designed to reduce interruptions in ICUs. The aim of the study was to investigate whether ICU nurses who receive a higher number of workplace interruptions commit more clinical errors and procedural failures than those who receive a lower number of interruptions. METHODS: We conducted a prospective controlled trial in a high-fidelity ICU simulator. A volunteer sample of ICU nurses from a single unit prepared and administered intravenous medications for a patient manikin. Nurses received either 3 (n = 35) or 12 (n = 35) scenario-relevant interruptions and were allocated to either condition in an alternating fashion. Primary outcomes were the number of clinical errors and procedural failures committed by each nurse. RESULTS: The rate ratio of clinical errors committed by nurses who received 12 interruptions compared with nurses who received 3 interruptions was 2.0 (95% confidence interval = 1.41-2.83, P < 0.001). The rate ratio of procedural failures committed by nurses who received 12 interruptions compared with nurses who were interrupted 3 times was 1.2 (95% confidence interval = 1.05-1.37, P = 0.006). CONCLUSIONS: More workplace interruptions during medication preparation and administration lead to more clinical errors and procedural failures. Reducing the frequency of interruptions may reduce the number of errors committed; however, this should be balanced against important information that interruptions communicate.

Improving the Quality of Evaluation Data in Simulation-Based Healthcare Improvement Projects: A Practitioner's Guide to Choosing and Using Published Measurement Tools.

STATEMENT: Simulation is increasingly being used in healthcare improvement projects. The aims of such projects can be extremely diverse. Accordingly, the outcomes or participant attributes that need to be measured can vary dramatically from project-to-project and may include a wide range of nontechnical skills, technical skills, and psychological constructs. Consequently, there is a growing need for simulation practitioners to be able to identify suitable measurement tools and incorporate them into their work. This article provides a practical introduction and guide to the key considerations for practitioners when selecting and using such tools. It also offers a substantial selection of example tools, both to illustrate the key considerations in relation to choosing a measure (including reliability and validity) and to serve as a convenient resource for those planning a study. By making well-informed choices, practitioners can improve the quality of the data they collect, and the likelihood that their projects will succeed.

Simulating a self-inflicted facial gunshot wound with moulage to improve perceived realism, immersion, and learning in simulation-based airway management training.

Moulage is used to create mock wounds and injuries for clinical education and training. We developed a moulage technique to simulate a facial gunshot wound for use in simulation-based training. We removed sections of a manikin's face and used moulage materials to mock various aspects of the wound. The manikin was used in a simulated scenario that teaches clinicians how to manage a complicated airway. The moulage was evaluated with a self-report questionnaire that assessed participants' perceptions of the realism of the wound, the degree to which the wound contributed to their scenario immersion, and the degree to which the wound enhanced their learning experience on a 5-point Likert scale ranging from 'strongly disagree' to 'strongly agree'. Participants' average response to each item was significantly higher than the neutral midpoint, and the median response was 'strongly agree'. Our work suggests that the simulated facial gunshot wound contributed to perceived scenario immersion and enhancement of the learning experience, supporting existing literature that suggests moulage is a valuable tool in healthcare simulation. Future work could investigate the effect of moulage using objective measures and explore the potential to use extended reality technology in conjunction with moulage to improve immersion even further.

From bartending interruptions to medication delivery interruptions: Managing the risks of a high-fidelity simulation study with pilot research.

In this paper we describe the risks of complex applied research, especially in work domains where professional practitioners are scarce. For such research, careful preparation and piloting is needed, especially when estimating sample size is required for a full study. However, such pilot work may reduce the potential sample size for the full study. We describe how the these issues have been addressed in applied psychology contexts. We then present a case study illustrating how we determined sample size for a study investigating the impact of workplace interruptions on errors that intensive care unit nurses might make during medication preparation and administration. The pilot work was performed in a functionally related domain to nursing-bartending-and bartender participants filled cocktail orders. Pilot 1 investigated performance with 0 interruptions and applied a model from a field observation to estimate probable effect sizes and sample sizes with 1 or 4 interruptions per medication scenario. Pilot 2 collected empirical data on the effect of 1 or 4 interruptions per cocktail scenario on cocktail errors and estimated sample size for the medication study, which was subsequently successfully run. The applied community could benefit from further discussions about these issues and the means for addressing them. (PsycInfo Database Record (c) 2020 APA, all rights reserved).